J Korean Diabetes.  2013 Dec;14(4):178-181. 10.4093/jkd.2013.14.4.178.

Role of Sarcopenia in Diabetes Mellitus

  • 1Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea. bard95@hanmail.net


One of the important physical changes associated with aging is a decline in muscle mass and strength. Such change is known to occur starting in the early thirties, and multiple factors such as ethnicity, gender, genetic factors, lifestyle, and underlying medical conditions intricately affect this phenomenon. Especially in elderly people, sarcopenia is crucial for declining physical function and quality of life associated with such physiologic changes, and it is also considered to be a risk factor for chronic diseases such as type 2 diabetes mellitus. In this article, I briefly describe the definition, clinical implications, and influence on diabetes mellitus of sarcopenia, and discuss current clinical recommendations for preventing sarcopenia in diabetic patients.


Sarcopenia; Aging; Diabetes mellitus type 2; Exercise

MeSH Terms

Chronic Disease
Diabetes Mellitus*
Diabetes Mellitus, Type 2
Life Style
Quality of Life
Risk Factors


  • Fig. 1. Suggestive mechanism of diabetes in the viewpoint of the sarcopenia. ROS, reactive oxigen species.



1. Harris T. Muscle mass and strength: relation to function in population studies. J Nutr. 1997; 127(5 Suppl):1004S–1006S.
2. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011; 12:249–56.
3. Zamboni M, Zoico E, Scartezzini T, Mazzali G, Tosoni P, Zivelonghi A, Gallagher D, De Pergola G, Di Francesco V, Bosello O. Body composition changes in stable-weight elderly subjects: the effect of sex. Aging Clin Exp Res. 2003; 15:321–7.
4. Rosenberg IH, Roubenoff R. Stalking sarcopenia. Ann Intern Med. 1995; 123:727–8.
5. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998; 147:755–63.
6. Janssen I. Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study. J Am Geriatr Soc. 2006; 54:56–62.
7. He Q, Heo M, Heshka S, Wang J, Pierson RN Jr, Albu J, Wang Z, Heymsfield SB, Gallagher D. Total body potassium differs by sex and race across the adult age span. Am J Clin Nutr. 2003; 78:72–7.
8. Cree MG, Newcomer BR, Katsanos CS, Sheffield-Moore M, Chinkes D, Aarsland A, Urban R, Wolfe RR. Intramuscular and liver triglycerides are increased in the elderly. J Clin Endocrinol Metab. 2004; 89:3864–71.
9. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39:412–23.
10. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002; 50:889–96.
11. Kim TN, Yang SJ, Yoo HJ, Lim KI, Kang HJ, Song W, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. Int J Obes (Lond). 2009; 33:885–92.
12. Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, Kim KW, Lim JY, Park KS, Jang HC. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care. 2010; 33:1652–4.
13. Kim YS, Lee Y, Chung YS, Lee DJ, Joo NS, Hong D, Song Ge, Kim HJ, Choi YJ, Kim KM. Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. J Gerontol A Biol Sci Med Sci. 2012; 67:1107–13.
14. Wang C, Bai L. Sarcopenia in the elderly: basic and clinical issues. Geriatr Gerontol Int. 2012; 12:388–96.
15. Zadik Z, Chalew SA, McCarter RJ Jr, Meistas M, Kowarski AA. The influence of age on the 24-hour integrated concentration of growth hormone in normal individuals. J Clin Endocrinol Metab. 1985; 60:513–6.
16. SSipilä S, Narici M, Kjaer M, Pöllänen E, Atkinson RA, Hansen M, Kovanen V. Sex hormones and skeletal muscle weakness. Biogerontology. 2013; 14:231–45.
17. Lang CH, Frost RA, Nairn AC, MacLean DA, Vary TC. TNF-alpha impairs heart and skeletal muscle protein synthesis by altering translation initiation. Am J Physiol Endocrinol Metab. 2002; 282:E336–47.
18. SHerbst A, Pak JW, McKenzie D, Bua E, Bassiouni M, Aiken JM. Accumulation of mitochondrial DNA deletion mutations in aged muscle fibers: evidence for a causal role in muscle fiber loss. J Gerontol A Biol Sci Med Sci. 2007; 62:235–45.
19. SConley KE, Jubrias SA, Esselman PC. Oxidative capacity and ageing in human muscle. J Physiol. 2000; 526(Pt 1):203–10.
20. Karakelides H, Nair KS. Sarcopenia of aging and its metabolic impact. Curr Top Dev Biol. 2005; 68:123–48.
21. Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus of Korean Diabetes Association. Park IeB, Kim J, Kim DJ, Chung CH, Oh JY, Park SW, Lee J, Choi KM, Min KW, Park JH, Son HS, Ahn CW, Kim H, Lee S, Lee IB, Choi I, Baik SH. Diabetes epidemics in Korea: reappraise nationwide survey of diabetes "diabetes in Korea 2007". Diabetes Metab J. 2013; 37:233–9.
22. Roubenoff R. Sarcopenic obesity: does muscle loss cause fat gain? Lessons from rheumatoid arthritis and osteoarthritis. Ann N Y Acad Sci. 2000; 904:553–7.
23. Chin SO, Rhee SY, Chon S, Hwang YC, Jeong IK, Oh S, Ahn KJ, Chung HY, Woo JT, Kim SW, Kim JW, Kim YS, Ahn HY. Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009. PLoS One. 2013; 8:e60119.
24. SColberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B. American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010; 33:e147–67.
25. Gordon BA, Benson AC, Bird SR, Fraser SF. Resistance training improves metabolic health in type 2 diabetes: a systematic review. Diabetes Res Clin Pract. 2009; 83:157–75.
26. Ryan AS, Hurlbut DE, Lott ME, Ivey FM, Fleg J, Hurley BF, Goldberg AP. Insulin action after resistive training in insulin resistant older men and women. J Am Geriatr Soc. 2001; 49:247–53.
27. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. JAMA. 1994; 272:1909–14.
Full Text Links
  • JKD
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr